CEA、AFP和CA242在胃癌病理诊断及预后评估中的作用

目的 探讨肿瘤标志物血清癌胚抗原(CEA)、甲胎蛋白(AFP)及胃肠道癌抗原(CA242)在胃癌病理诊断及预后评估中的应用价值.方法 选择确诊的胃癌患者71例为胃癌组,另随机选择同期确诊的胃部良性病变者71例为良性病变组,同期门诊检查的健康人群71例为健康对照组,清晨空腹抽取静脉血3 ml,检测CEA、AFP及CA242浓度,分析其在胃癌早期诊断及预后评估中的作用.结果 胃癌组患者的血清CEA、CA242和AFP浓度均高于良性病变组和健康对照组,差异有统计学意义(P<0.01).CEA、CA242和AFP诊断胃癌的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为96.07%、75.82%、83.1%、69.01%、97.18%;94%、73.91%、80.99%、66.2%、95.77%;80%、56.41%、60.56%、28.17%、92.96%.随访复发的患者中,CEA、CA242和AFP诊断阳性病理所占比例高于阴性(P<0.05);无癌生存患者中,CEA、CA242和AFP诊断阳性病理所占比例低于阴性(P<0.05).结论 CEA、CA242和AFP均可作为胃癌早期诊断的敏感性指标,可以用于预后评估.

The significance of CEA and AFP,CA242 in pathological diagnosis and prognostic evaluation of gastric cancer

Objective To explore the significance of carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and gastrointestinal cancer antigen (CA242) in pathological diagnosis and prognostic evaluation of gastric cancer.Methods Seventy-one patients with gastric cancer who were diagnosed definitely in our hospital from January 2012 to June 2013 were selected as gastric cancer group,at the same time, the other 71 patients with gastric benign lesions were served as benign lesion group,moreover, the 71 healthy subjects were served as control group.The serum levels of CEA,AFP and CA242 were detected and compared among the three groups.Results The serum levels of CEA,CA242 and AFP in gastric cancer group were significantly higher than those in benign lesion group and control group (P<0.01).The sensitivity, specificity, accuracy,positive predictive value, negative predictive value of CEA in diagnosis of gastric cancer were 96.07%, 75.82%, 83.1%, 69.01%,97.18%,respectively,which of CA242 were 94%, 73.91%, 80.99%, 66.2%, 95.77%, respectively,which of AFP were 80%,56.41%, 60.56%,28.17%,92.96%,respectively.Among the patients receiving follow-up, the patients with positive CEA,CA242 and AFP were more than the patients with negative CEA,CA242 and AFP ,however, among the cancer-free survival patients,the proportion of patients with positive CEA,CA242and AFP was lower than that of patients with negative CEA,CA242 and AFP.Conclusion The CEA,CA242 and AFP can be used as sensitive indexes in early diagnosis of gastric cancer,which can also be used for prognostic assessment.